BOLTON has been taking a ‘Morecambe and Wise’ approach to handling patients in one of its busiest departments.

The classic joke by the iconic comic duo of “I’m playing all the right notes — but not necessarily in the right order” has been used to describe some of the admission and discharge processes at Royal Bolton Hospital.

It followed a one-day visit by NHS Service Improvement Team to the hospital’s A&E to assess how to improve the performance of the service.

Chief executive Jackie Bene said: “We have all the ingredients of a successful system, we just need to put them together so we know what we need to do.”

Speaking at yesterday’s Bolton NHS Foundation Trust board meeting, chief operating officer Andy Ennis added: “This is about finessing, not redesigning what we do. It’s the Morecambe and Wise principle.

“They are prescribing what we should do and we are in discussion about what we need.”

In a letter to Ms Bene by the improvement team it fed back on the ‘streaming’ process for patients through assessment, the emergency department, inpatient ward and discharge.

Areas it highlighted included a minimum wait for triage patients of 45 minutes “no matter how quiet the department is”, an unclear role for the integrated discharge team, and reliance on transferring patients to community-based beds rather than a ‘home first ‘ approach.

It went on to state that there was a “missed opportunity” to have the assessment process completed in patient’s own home with the care needed already available in the borough.

The board agreed the length of stay in beds was on the increase and the up to now the focus had been moving patients through the hospital process for treatment rather than looking to get them home.

Mr Ennis added: “They have pulled out all the things which are wrong and put into one letter.

“We have been focussed on discharge to beds, and this visit has been a wake up call to me. When you are so involved in the process you don’t necessarily realise you are doing it. We have not been thinking of how to get people home, but how to get them to the next bed.

“We know the discharge process is not working right. It is not just us, we are working with social care and discharge teams to bring it all together.”

“This is a really good opportunity for us to target the right areas and improve them .”